Miranda Kay Benson, MAT, AT, ATC
Specialist/Technologist, Athletic Trainer in Quincy, IL. Individual provider (NPI-1).
NPI number1548636780
StatusActive
Last updated in NPPESDec 15, 2023
Details
- NPI
- 1548636780
- Entity type
- Individual (NPI-1)
- Name
- Miranda Kay Benson
- Credential
- MAT, AT, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2015
- Certification date
- Aug 7, 2022
- Last updated
- Dec 15, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 096.004631 | IL | Yes |
Practice location
1800 College AveQuincy, IL 62301-2670
Phone 217-228-5432 · Fax 217-228-5604
Mailing address
606 N 5th StCanton, MO 63435-1100
Phone 920-639-9272
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Athletic Trainer providers in Quincy · All 1,678 providers in Quincy
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